About Annual Physicals
An Overview Of The Annual Physical Exam
A physical exam is a common feature encountered on many visits to the doctor’s office. Surprisingly, while the routine annual physical is utterly familiar to patients and doctors alike, there is no absolute list of “must-haves” that make it up. Good doctors may be either thorough or brief; the important thing is to make a fair assessment of your specific health concerns and provide effective counseling.
Typical items checked in an annual physical include:
1) History
This is the part of the physical where you can bring your doctor’s attention to any specific concerns you may have. For his or her part, your doctor will gather information about your general behavior and health concerns; expect basic questions on alcohol and tobacco use, sexual activity, diet, and exercise. The history portion also involves a quick check of your vaccinations and updates to your personal and family medical history as necessary.
2) Vital Signs
Your doctor may check some or all of the following:
* Blood Pressure. Normal healthy blood pressure is 120 or less over 80 or less. High blood pressure, also known as hypertension, sets in at 130 over 80 or higher.
* Heart Rate. Normal values range from 60 to 100. Many people with heart rates below 60 are perfectly healthy.
* Respiration Rate. A healthy adult typically breathes between 12 and 16 times a minute. Respiration rates over 20 breaths a minute may indicate heart or lung issues.
* Temperature. The healthy average falls at 98.6 degrees, but your resting temperature may be slightly higher or lower without indicating a problem.
* General Appearance. Doctors have a formidable ability to collect health information simply by observing and interacting with you. Skin health, mobility, and mental function can all be assessed during the course of conversation.
3) Heart Exam
Your doctor will usually listen to your heartbeat with a stethoscope. Irregularities to watch out for here include heart murmurs or an irregular heartbeat. These may be signs of heart disease or other cardiovascular problems.
4) Lung Exam
This is another stethoscope test. Your doctor will listen to any unusual sounds while you breathe. Crackles, wheezes, impaired breathing, and other irregularities may be clues to issues with your lungs or heart.
5) Head and Neck Exam
When you open up for your doctor and say “ah,” he or she is checking numerous indicators. Your teeth and gums provide a wealth of information about your overall health. Your doctor may also examine ears, eyes, lymph nodes, thyroid, nose, sinuses, and carotid arteries at this point.
6) Abdominal Exam
A range of physical examination techniques (e.g. tapping your stomach) is used to check the size of your liver, probe for tenderness, and detect signs of abdominal fluid retention. Your doctor may also use a stethoscope to listen for bowel sounds.
7) Neurological Exam
These brief exercises will assess reflexes, balance, nerves, muscle strength, and mental condition.
8) Dermatological Exam
The skin and fingernails are examined in search of both skin problems and symptoms that may indicate issues in other parts of the body.
9) Extremities Exam
Your doctor needs to check for physical and nervous changes. This may include checking your joints for function and range of motion and checking pulses in your arms and legs.
10) Lab Tests
Annual physicals do not necessarily require laboratory testing. Some common tests are routinely called for if your doctor notes any potential issues. These may include:
* Complete blood count
* Urinalysis (UA)
* Chemistry panel
Tests are rarely diagnostic in themselves; they only serve to provide more information about a problem which is already evident.
The American Heart Association recommends a screening lipid panel (cholesterol test) every four to six years. Your doctor may be conducting cholesterol tests more frequently if you have risk factors or symptoms of heart disease. Abnormalities with your cholesterol levels are closely tied to increased heart attack and stroke risks.
If you have diabetes risk factors, including being overweight, your doctor will probably check your blood sugar during your physical. The American Diabetes Association also recommends testing all adults for diabetes regardless of weight after the age of 45.
The Goal Of The Physical Exam Is Prevention
Your annual exam gives you a terrific opportunity to dedicate yourself to screening for future problems and taking preventative steps. Some key considerations:
* At age 50 you need to begin screening for colorectal cancer. You may want to start earlier if you have a family history of colorectal cancer or other risk factors.
* Some women need to start getting screened annually for breast cancer. The American Cancer Society recommends starting this between the ages of 40 and 44 if the patient so desires. Annual mammograms are more strongly recommended for women between 45 and 54; at age 55 and older, mammograms every two years are sufficient. Women who wish to continue screening annually can do so. Women are advised to consult a doctor or other caregiver to discuss their long-term breast cancer screening options.
Speaking very generally, healthy behaviors and lifestyle choices are a more effective and efficient way to prevent illness than taking medicine. A few easy prescription-free recommendations:
* Try to get 30 minutes of gentle exercise (e.g. brisk walking) on most days, aiming at a total of 150 minutes per week. Do some form of strength training twice a week. This moderate physical activity will dramatically reduce your risk of contracting cardiovascular disease, diabetes, and some forms of cancer.
* Keep your diet low in animal fats and primarily plant-based.
* Don’t smoke.
Is The Annual Physical Exam Really Necessary?
Many doctors and patients swear by the annual physical. Some research indicates the exam actually doesn’t help much and may end up encouraging more testing than is necessary.
Both individual doctors and their professional organizations have suggested the annual physical is unnecessary for generally healthy people.
Getting a little exercise, maintaining a healthy weight, and refraining from smoking is all most people need to do, whether or not they’re dutifully getting a physical every year. It doesn’t hurt to maintain a regular relationship with your doctor, though! As long as you and your caregiver are keeping track of your overall health and taking wise preventative steps, the examination details can be adjusted to suit your needs.